Contract Pharmacy Details

WALGREEN CO.
CH056420 LAWNDALE CHRISTIAN HEALTH CENTER

Covered Entity Details

Entity Name

LAWNDALE CHRISTIAN HEALTH CENTER

Subdivision Name

Lawndale Christian Health Center Main Clinic

Type

HRSA-Funded Health Center

340B ID

CH056420

Entity Address

3860 W Ogden Ave
Chicago, IL 60623-2460

Grant Number

H80CS00725

Participating Start Date

12/1/1992

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06641
1614 W 47TH STREET
CHICAGO, IL 60609-3245

Pharmacy Comments

Contract Details

Approval Date

7/14/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

BRUCE MILLER, CEO
(872) 588-3012

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/14/2014

340B Drug Pricing Program Database